FUNCTIONAL METABOLIC CHARACTERISTICS OF INTACT PIG LIVERS DURING PROLONGED EXTRACORPOREAL PERFUSION: POTENTIAL FOR A UNIQUE BIOLOGICAL LIVER-ASSIST DEVICE1
FUNCTIONAL METABOLIC CHARACTERISTICS OF INTACT PIG LIVERS DURING PROLONGED EXTRACORPOREAL PERFUSION: POTENTIAL FOR A UNIQUE BIOLOGICAL LIVER-ASSIST DEVICE1
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完整猪肝在长时间体外灌注过程中的功能代谢特征：独特的生物肝脏辅助装置的潜力1
DOI：
10.1097/00007890-200108150-00007
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发表时间：
2001
期刊：
影响因子：
6.2
通讯作者：
L. Hannoun
中科院分区：
文献类型：
--
作者：
D. Borie;D. Eyraud;E. Boleslawski;A. Lemoine;M. Sebagh;D. Cramer;J. Roussi;F. Imbert‐Bismut;G. Germain;L. Hannoun
背景基于猪肝细胞盒或全猪肝灌注的肝脏支持器械的临床开发受到以下因素的阻碍：使用足够的肝细胞质量提供足够的代谢支持的能力、有限的灌注时间以及患者暴露于猪人畜共患病的可能性。方法.我们设计了一个原始的系统，其中一个孤立的完整的猪肝体外灌注生理条件下，在一个闭环回路与同种异体猪血液和主要的生理和功能参数的持续监测。灌注回路还包括界面膜以提供患者和肝脏灌注循环的分离。结果长时间（6-21小时）肝脏灌注未产生显著的肝损伤，如血清转氨酶水平的适度升高、主要生化参数（包括钾）的稳定性和正常细胞形态的维持所反映的。最佳肝功能记录为乳酸消耗量，控制血糖，凝血研究和功能测定的结果。灌注肝脏清除峰值胆红素和氨浓度的82%和79%，在整个灌注过程中清除动力学相同。吲哚菁绿色清除率与取出手术前在活体供体中观察到的相同。结论.总之，本文所述的体外猪肝灌注设备允许长时间的最佳猪肝功能。提供供体器官和受体分离的微孔膜和高水平的功能活性表明这种形式的肝脏代谢支持可能具有重要的临床应用。
Background. The clinical development of liver-support devices based on perfusion of either pig hepatocytes cartridges or whole pig livers has been hampered by the ability to use sufficient liver cell mass to provide adequate metabolic support, limited perfusion times, and the potential for patient exposure to pig zoonotic diseases. Methods. We designed an original system in which an isolated intact pig liver was perfused extracorporeally under physiological conditions in a closed loop circuit with allogeneic pig blood and constant monitoring of major physiological and functional parameters. The perfusion circuit further included an interface membrane to provide for separation of patient and liver perfusion circulation. Results. Prolonged (6–21 hr) liver perfusion did not produce significant liver damage as reflected by modest rises in the levels of the serum transaminases, stability of main biochemical parameters (including potassium), and the maintenance of normal cellular morphology. Optimal liver function was documented as measured by lactate consumption, control of glycemia, and the results of clotting studies and functional assays. The perfused liver cleared 82% and 79% of peak bilirubin and ammonia concentrations with clearing kinetics identical throughout perfusion. Indocyanine green clearance was identical to that observed in the living donor before explant surgery. Conclusions. In conclusion, the extracorporeal pig liver perfusion apparatus described here allows optimal pig liver function for prolonged periods of time. The microporous membrane to provide separation of donor organ and recipient and the high level of functional activity suggest that this form of liver metabolic support may have important clinical applications.
生物人工肝治疗严重肝衰竭的临床经验。
影响因子：
9
作者：
Watanabe,FD;Mullon,CJ;Hewitt,WR;Arkadopoulos,N;Kahaku,E;Eguchi,S;Khalili,T;Arnaout,W;Shackleton,CR;Rozga,J;Solomon,B;Demetriou,AA
通讯作者：
Demetriou,AA